An 8-year-old boy presented with a 6-month progressively enlarging painless nasal lesion, initially misdiagnosed as infiltrative-suppurative trichophytosis and treated with oral griseofulvin and topical sertaconazole without improvement. The patient's father had pulmonary tuberculosis, and the child had not received BCG vaccination. Examination revealed a large, well-defined, red-brown vegetative plaque involving most of the nose. The surface was irregular and moist, covered with adherent yellow-brown and grayish-white crusts. Superficial erosions and small ulcers were present. Several smaller reddish-brown satellite plaques with crusts and fine scaling surrounded the lesion (Figure 1). Biopsy was not performed. Clinical material from the nasal cutaneous lesion was obtained using a sterile swab and cultured in the BACTEC MGIT 960 (an automated culture system for the detection of mycobacteria), yielding Mycobacterium tuberculosis; Xpert MTB/XDR confirmed a drug-susceptible strain. Chest CT revealed focal pulmonary lesions, but the sputum was negative. The patient received 2 months of rifampicin, isoniazid, pyrazinamide, and ethambutol, followed by 4 months of rifampicin and isoniazid (2RZEH/4RH), with visible improvement after 1 month. No recurrence was observed during follow-up. Cutaneous tuberculosis can mimic other granulomatous or infectious diseases. In chronic, nonhealing lesions, lupus vulgaris should be considered in the differential diagnosis, especially in endemic regions 1-3. Viktor Pushkarenko: data curation, writing – original draft preparation. Yana-Karina Zovdun: conceptualization and methodology. Olga Pushkarenko: Supervision. The authors received no specific funding for this work. The parents/guardians of minor patients have given written informed consent for their child's participation in the study, as well as for the use of their child's de-identified, anonymized, aggregated data, and case details (including photographs) for publication. Ethical Approval: not applicable. The authors declare no conflicts of interest. The data that support the findings of this study are openly available in repository name, for example, “figshare” at doi, reference number reference number.
Pushkarenko et al. (Mon,) studied this question.